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8. AMENDMENT-Ma <br /> IpAggtrpM Age, emen't <br /> (must fill out all pages in section 8) <br /> Are you requesting approval to utilize a management company through a management agreement? <br /> If yes,please fill out section 8. ( Yes ( No <br /> Please provide a narrative overview of the Management Agreement.Attach additional pages,if necessary. .......... <br /> ...................... <br /> .............................................................. —------ .......... .. ................................ <br /> IMPORTANT NOTE:A management agreement is where a licensee authorizes a third party to control the daily operations of the <br /> license premises,while retaining ultimate control over the license,through a written contract. This does not'pertain to a liquor <br /> license manager that is employed directly by the entity. <br /> 8A. MANAGEMENT ENTITY <br /> List all proposed individuals or entities that will have a direct or indirect,beneficial or financial interest in the management Entity(E.g. <br /> Stockholders,Officers,Directors,LLC Managers,LLP Partners,Trustees etc.). <br /> Entity Name Address Phone <br /> .......... ........ <br /> . ....................................... <br /> ...........I......................................... ......................... 7 <br /> L.......... ............. ............... <br /> Name of Principal Residential Address SSN DOB <br /> ........... .............. <br /> ...................... <br /> .............., <br /> ............................... ................. <br /> .......... ............. <br /> Title and or Position Percentage of Ownership Director US Citizen MA Resident <br /> ................... .................... ....................................................... <br /> ................................. <br /> r........................................................."_ .......... <br /> (' Yes No <br /> ­­.. ................................................. <br /> C Yes C No Yes ( No <br /> Name of Principal Residential Address SSN DOB <br /> .................................... <br /> .......... .................. ............... <br /> Titl .e and or Position Percentage of Ownership Director US Citizen MA Resident <br /> .................... ................................................................. ........................................ <br /> ............... <br /> C Yes No <br /> ............................... ............�,­'' 16;: <br /> Name of Principal Residential Address SS DOB <br /> ......................................... .......... ........... ........ <br /> ...................... <br /> Title and or Position Percentage of Ownership Director US Citizen MA Resident <br /> �m. . m. .... �„w��� <br /> .......J Yes N( es No ( Yes ( No <br /> ....... —..... <br /> r Y", 'r............................................ <br /> ............................................................... <br /> Name of Principal Residential Address SSN DOB <br /> .......................................................... <br /> ......................... ......... ......... .............. <br /> ........... <br /> Title and or Position Percentage of Ownership Director US C iti ze n MA Resi dent <br /> -—-—----—----------------------------------- <br /> ........... <br /> Y C Yes No <br /> Yes ( No <br /> CRIMINAL HISTORY <br /> ........................... ........... <br /> Has any individual identified above ever been convicted of a State,Federal or Military Crime? C Yes No <br /> If yes,attach an affidavit providing the details of any and all convictions. El I I............. <br /> 8B. EXISTING_MAN AGEMENT,,,,,.AGREEMENTS AND INTERE S TwwIN AN ALCOHOLIC BEVERAGES LICENSE <br /> ­7-Does any individual or entity identified in question 8 ------------ <br /> A,and applicable attachments, have any direct or indirect,beneficial or financial <br /> interest in any other license to sell alcoholic beverages;and or have an active management agreement with any other licensees? <br /> Yes No If Yes,list in table below.Attach additional pages,if necessary,utilizing the,table format below. <br /> ..........."I <br /> ........... ................................................................................................................................................................................. ............................................... ...................................... ............................. .............. ........................................ <br /> Name License Type License Name Municipality <br /> .......... ................................. <br /> ............ .............. ....... ................ ........._.­___"­ "..................... <br /> ............................................................................. ............................ ........... ............... .......................... ......................._­_­......................... <br /> ------------- .................................................... .................... _'_.................... <br />